Permit C 1TY OFTIGARD PLUMBING PERMIT
Alk DEVELOPMENT SERVICES PERMIT #: PLM2000 -00096
DATE ISSUED: 3/30/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-41p\
SITE ADDRESS: 16342 SW 72ND AVE B -04 PARCEL: 2S113AA -00100
SUBDIVISION: ROSEWOOD ACRE TRACTS �` ZONING: I -L
BLOCK: LOT: OOA JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: - WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Cap 4 lavatories, 1 shower, 3 water closets, 1 urinal and 1 floor drain /floor sink 2" For 2 EDU credits.
• SRW2000 -00096
FEES
Owner:
Type By Date Amount Receipt
PACIFIC REALTY ASSOCIATES PRMT DEB 3/30/00 $50.00 00001065
15350 SW SEQUOIA PKWY #300 -WMI
5PCT DEB 3/30/00 $4.00 00001065
PORTLAND, OR 97224
Total $54.00
Phone 1:
Contractor:
DEAN WARREN PLUMBING
3111 SE 13TH
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Phone 1: 236 -4152 Insp existing /capped fixtures
Reg #: LIC 172 Final Inspection
PLM 26 -83PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080.
You ma • opies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Iss d By: ` ,0 jab � ) Permittee Signature:
Call (503) ; 9-4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD Plumbing Permit Application Plan Check#
13125 SW HALL BLVD. Commercial and Residential Rec'd By
TIGAR OR 97223 Date Rec'd 3/2: 01)
(503) 639 -4171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Per PUtI ea it L oc
P 9 PP P Related SWR # �� � z��
Called 3 28'" °045
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
Job SPEC, S PACE _ _ Sink 1 11.50
Address Street Address Suite Lavatory 1.4 11.50
/ 6 Li a 51.4) - 7a Tub or Tub /Shower Comb. Or 11.50
Bldg # City/State ( Zip Shower Only I 11.50
re•A Water Closet/Urinal (Specify) .-4 11.50
Nape r�4-�s� Dishwasher 11.50
Owner Mailing Address Suite : At Urinal I 11.50
/5350 54.. 56494,14 pk"4 300 Garbage Disposal 11.50
City /State Zid P Laundry Tray 11.50
7 & 10 ail -Iv 3Od
Name Washing Machine /Laundry Tray (Specify) 11.50
1
Floor Drain/Floor Sink 2" O 11.50
Occupant Mailing Address Suite, 3" ! 11.50
4° 11.50
City/State Zip Phone
Water Heater 0 conversion 0 like kind 11.50
• ame Gas piping requires a separate mechanical permit.
wAkaew .D MFG Home New Water Service 28.00
Aa.4
Contractor Mailing Address Suite MFG Home New San/Storm Sewer 28.00
Z 1 Lk ,sue 1.3 Hose Bibs 11.50
Prior to permit OM/State Zip Phone Roof Drains 11.50
issuance, a copy fog. / L, 4 9 7D4_,Q 0 ``
v Drinking Fountain 11.50
all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if n 1 7. /aJa3ioeb Other Fixtures (Specify) 15.00
expired in COT Plumbing Lic. # Exp. Date
database '
Al
P B . 6 • °
Name
Architect Sewer -1st 100' 38.00
Or Mailing Address Suite Sewer - each additional 100' 32.00
Water Service - 1st 100' 38.00
Engineer City/State Zip Phone Water Service - each additional 200' • 32.00
Describe work to be done: Storm & Rain Drain - 1st 100' 38.00
New 0 Repair 0 Replace with like kind: Yes 0 No O Storm & Rain Drain- each additional 100' 32.00
Residential 0 Commercial Commercial Back Flow Prevention Device 32.00
Additional description of work:
Y�C�® / A Tc.c►E_ � S Residential Backflow Prevention Device* 19.00
Catch Basin 11.50
Are you capping, oving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
Yes No 0 Inspections per/hr
If yes, see back of orm to indicate work performed by r Rain Drain, single family dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL 5° �
I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required it Quantity Total is > 9
given is correct, that 1 am the owner or authorized agent of the owner, and *SUBTOTAL
that plans submitted are in compliance with egon State Laws.
Signatu o /Agent Date
8% SURCHARGE
3la46o
Contact erson Name Phone
( 1 6"/" • oZ36-11r5;. **PLAN REVIEW 25% OF SUBTOTAL
1 BATH HOUSE $178.00 Required only if fixture qty. total is > 9 • BATH HOUSE 5250.00 TOTAL "7
3ATH HOUSE $285.00
„ibis tee Includes all plumbing fixtures in the dwelling and the first Beddow permit fee is $50 + 8% surcharge. except Residential Bacow Prevention J��'
1 100 feet of sanitary sewer stone sewer and water service) Device, which is $25 + 8% surcharge
"AII New Commercial Buildings require plans with isometric or riser diagram and •
plan review.
Mist/Norms tplumapp.doc 10/1199 - - 9.I..L
PLEASE COMPLETE:
Fixture Type Quantity by Work Perforrned
New Moved I Replaced °Removed /Capped
Sink -
Lavatory y
Tub or Tub /Shower Combination
Shower Only /
Water Closet
Dishwasher
Urinal
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2" /
3"
4"
Water Heater
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
•
I: ldstsVmmslplumapp.doc 10/1/99
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 1 4/3/00 r 0 AM X PM BLD
Location ) CO `"1 ■ 'A Stitd6W '7 - MEC
Contact Person 0,e a/it) Ph 0, �- q / S LM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof /Misc:
Final
PASS PART FAIL
�MBIN ) •
Posf1113
tISZIBIte•
Top Out
Water Service •
Sanitary Sewer
Rain Drains
PP PART FAIL
IVIECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL -
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA W7/,1
Approach /Sidewalk Date Inspector Ext Li 5/61 Other _
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.